Varies by plan

Does Healthsun Health Plans, INC. require prior authorization for Premarin?

Prior authorization for Premarin differs across Healthsun Health Plans, INC.'s Medicare Part D plans and product strengths — 6 of 6 Premarin products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.

Some plans require authorization and others do not. The member's specific plan decides.

By product strength

RxNorm product	Plans covering	Require prior auth	Status
estrogens, conjugated (USP) 0.625 MG Oral Tablet [Premarin]150840	13 / 13	13	Prior authorization required
estrogens, conjugated (USP) 1.25 MG Oral Tablet [Premarin]202301	13 / 13	13	Prior authorization required
estrogens, conjugated (USP) 0.3 MG Oral Tablet [Premarin]208513	13 / 13	13	Prior authorization required
estrogens, conjugated (USP) 0.9 MG Oral Tablet [Premarin]208949	13 / 13	13	Prior authorization required
estrogens, conjugated (USP) 0.45 MG Oral Tablet [Premarin]404550	13 / 13	13	Prior authorization required
estrogens, conjugated (USP) 0.625 MG/ML Vaginal Cream [Premarin]688242	13 / 13	0	No prior authorization

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — estrogens, conjugated (USP) 0.625 MG Oral Tablet [Premarin]

Premarin has 6 products in the corpus; this table is for estrogens, conjugated (USP) 0.625 MG Oral Tablet [Premarin], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
HealthSun HealthAdvantage Plan (HMO)	H5431-001	3	Yes	No	No
HealthSun HealthAdvantage Plan (HMO)	H5431-012	3	Yes	No	No
HealthSun HealthAdvantage Plan (HMO)	H5431-013	3	Yes	No	No
HealthSun HealthAdvantage Plus (HMO)	H5431-017	3	Yes	No	No
HealthSun HealthAdvantage Plus (HMO)	H5431-018	3	Yes	No	No
HealthSun HealthAdvantage Plus (HMO)	H5431-020	3	Yes	No	No
HealthSun MediMax (HMO)	H5431-006	3	Yes	No	No
HealthSun MediSun Extra (HMO D-SNP)	H5431-019	3	Yes	No	No
HealthSun MediSun Full Dual Extra (HMO D-SNP)	H5431-026	3	Yes	No	No
HealthSun MediSun Full Dual Plus (HMO D-SNP)	H5431-025	3	Yes	No	No
HealthSun MediSun Plus (HMO D-SNP)	H5431-016	3	Yes	No	No
HealthSun VitalCare (HMO C-SNP)	H5431-021	3	Yes	No	No
HealthSun VitalCare (HMO C-SNP)	H5431-022	3	Yes	No	No

Source

Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File

Effective: 2026-06-30
Retrieved: 2026-07-19
SHA-256: e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Premarin at other payers

Or see Premarin across every payer at once.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.